WO2017222289A1

WO2017222289A1 - Device for manufacturing guide template for dental implant surgery

Info

Publication number: WO2017222289A1
Application number: PCT/KR2017/006491
Authority: WO
Inventors: 이태경
Original assignee: 이태경
Priority date: 2016-06-21
Filing date: 2017-06-21
Publication date: 2017-12-28
Also published as: KR20170143303A; KR101845488B1

Abstract

The disclosed device for manufacturing a guide template is characterized by comprising: robot arms which are connected in the order of "rotating-tilting-tilting-rotating-tilting-rotating" from a base to a working end of an end portion to enable six degrees-of-freedom motion; and a laser cutter and a marking pen installed on the working end, wherein an opaque cutting line is marked, by the marking pen, on a surface of a thermoplastic sheet closely attached on an oral model, and then the thermoplastic sheet is cut along the cutting line by the laser cutter so as to be able to be separated from the oral model.

Description

Guide template manufacturing device for dental implants

The present invention relates to an apparatus for producing a guide template which can induce the surgical procedure during an implant, in particular a dental implant procedure, to proceed precisely as planned.

Implant is implanted artificial tooth (fixture) made of metal (mainly titanium or titanium alloy) with excellent biocompatibility in the alveolar bone of the missing tooth, fused with the alveolar bone tissue, and then artificial tooth is formed on the artificial tooth It is a general term for dental surgery or artificial tooth itself, which allows people to live a daily life with a sense almost identical to their own teeth.

This implant has advantages such as long life and very similar to natural teeth, without damaging the surrounding teeth except for the teeth that need to be treated, compared to the method using a denture or a bridge. This is much lower and is getting more attention.

Briefly describing the method of implantation, first, the patient's gingival (gum) is incised to expose the alveolar bone, the position to insert the implant on the exposed alveolar bone is determined, and then a portion of the alveolar bone is made using a drilling tool such as a drill. By removing the hole, a hole for implanting the implant is formed. After fixing the fixture in the hole formed in the alveolar bone and covering the gingival, wait for a suitable period of time so that the fixture and the alveolar bone are sufficiently fused, and then expose the firmly fixed fixture and place the abutment and abutment on it. The implant procedure is completed by attaching the (crown). Here, according to the implant technique, the procedure of suturing the gingival and later dissecting the gingival may be omitted by installing a healing abutment on the fixture placed in the alveolar bone.

On the other hand, in order to implant the prosthesis in an excellent biomechanical, histological, functional, and aesthetic manner during implantation, a perforation operation must be performed at a precise position, direction, and depth. In many cases, a surgical guide is used.

In order to create such a guide template, the oral model that is the model must be prepared first. Traditionally, the impression material was used to obtain the upper and / or lower jaw of the subject, and then plaster was poured on it to simulate the upper and / or lower jaw of the subject. Recently, a model is directly produced by a rapid molding machine or a 3D printer based on 3D image data.

On the prepared oral model, the area of the tooth defect that requires the implant procedure is transferred as it is.The hole is drilled in accordance with the implant procedure plan, and the bushing for inducing the direction and depth of the drilling drill is detachably fixed. do.

Then, after curing by applying a curable resin to cover the fixed bushing and at least a few of the teeth around it, remove the member fixing the bushing and remove the resin from the oral model, the bushing for inducing the drill for drilling the implant The mounted guide template is complete.

Patent document 1 is an invention regarding the guide template which the applicant has registered, and patent document 2 is an invention regarding the fixing pin assembly for fixing a bushing on an oral model so that a bushing may be separated in a state embedded in a guide template. In addition, Patent Document 3 is a coordinate synchronization plate for precisely drilling a hole on the oral model according to an implant procedure plan established using a computer program, and Patent Document 4 is a hole in the oral model according to the synchronized coordinate information. As a multi-axis drilling machine, the present applicant has filed and registered many other inventions related to the guide template.

However, the conventional guide template is difficult to make a constant thickness because it is made by applying the curable resin on the oral model by hand, because of this, there is a tendency to apply a somewhat excessive curable resin in order to avoid the risk that the portion is made thin and the strength is not sufficient. have. Therefore, the guide template is made thick, and when it is inserted into the mouth of the patient feels uncomfortable and takes a long curing time.

In addition, the application of the curable resin by hand was difficult to create a guide template that follows the shape of the complex oral tissue as it is, and in this case it may not be mounted correctly without shaking when inserted into the patient's mouth. In order to solve this problem, Patent Document 1 attaches an elastic body to the inner surface of the guide template. The construction of these elastomers has brought about quite good effects, but requires additional work of attaching the elastomers, often causing them to fall off.

In addition, since the bushing embedded in the guide template may be detached when the curable resin is not completely adhered to the bushing surface, an operation of applying an adhesive to the bushing surface was required.

The present invention improves the problem of the process of applying the curable resin on the oral model by hand included in the process of making a guide template in the prior art, as described above, it can be precisely inserted into the oral cavity without shaking evenly, It is an object of the present invention to provide an apparatus for manufacturing a guide template for a implant procedure of a new structure that does not require additional work to securely secure the bushing.

In particular, it is an object of the present invention to provide an apparatus for manufacturing a guide template to automatically proceed to the finishing operation that is easy to adversely affect the quality of the final product according to the manual process when manufacturing the guide template as described above.

Guide template manufacturing apparatus according to the present invention, the robot arm capable of six degrees of freedom of movement in the order of "rotation-tilting-tilting-rotation-tilting-rotation" from the base to the end of the working end; And a laser cutting machine and a marking pen mounted on the working stage, wherein an opaque cutting line is displayed on the surface of the thermoplastic sheet adhered to the oral cavity model by the marking pen, and the thermoplastic cutting machine is formed by the laser cutting machine along the cutting line. And cut out the sheet so that it can be separated from the oral cavity model.

Here, the output of the laser cutting machine is characterized in that lower than the output capable of cutting out the thermoplastic sheet without the cutting line at one time, according to an embodiment of the present invention the output of the laser cutting machine is 2 ~ per 0.01πmm 2 It can be in the 6W range.

The thermoplastic sheet may be a transparent material.

And, the cut line is preferably displayed such that the thermoplastic sheet includes an undercut portion of the tooth on the oral cavity model.

On the other hand, the thermoplastic sheet may include a first thermoplastic sheet which is in direct contact with the oral cavity model, and a second thermoplastic sheet bonded to an outer side of the first thermoplastic sheet and having a greater thickness.

In one embodiment of the present invention, the thickness of the first thermoplastic sheet may be in the range of 0.3 to 0.75 mm, and the thickness of the second thermoplastic sheet may be in the range of 0.5 to 3.0 mm.

The thermoplastic sheet may be made of at least one resin selected from polyethylene (PE), polyvinyl chloride (PVC), acrylic, acrylic, ABS, and polycarbonate.

The guide template manufacturing apparatus of the present invention having the above configuration can accurately cut the thermoplastic sheet according to the work information designed on the computer program, thereby fundamentally solving the defect in the guide template due to the mistake that may occur during manual operation. have.

In particular, the guide template manufacturing apparatus of the present invention is configured to display an opaque cutting line in advance before cutting with a laser, the cutting line can significantly lower the output of the laser because it has the effect of increasing the absorption of the laser This solves a number of problems that can occur when using high power lasers.

In addition, the present invention also has the advantage that it is possible to manufacture the guide template from a thermoplastic sheet of a transparent material which is difficult to effectively irradiated laser light by displaying an opaque cut line on the surface of the thermoplastic sheet in advance.

1 shows a series of steps in preparing an oral model for producing a guide template.

2 is a view showing a series of steps for producing a guide template using the oral model prepared through the process of FIG.

3 is a perspective view of the completed guide template.

Figure 4 is a perspective view showing a guide template manufacturing apparatus according to the present invention.

5 is a side view of the guide template manufacturing apparatus of FIG.

Figure 6 is a photograph taken a guide template made of a transparent thermoplastic sheet.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings.

In describing the embodiments of the present invention, descriptions of well-known configurations that will be obvious to those skilled in the art will be omitted so as not to obscure the subject matter of the present invention. In addition, when referring to the drawings it should be considered that the thickness of the lines or the size of the components shown in the drawings may be exaggerated for clarity and convenience of description.

First, the overall manufacturing process of making the guide template to be manufactured by the present invention will be described with reference to FIGS. 1 and 2.

FIG. 1 is a diagram illustrating a series of steps for preparing an oral cavity model MD for manufacturing the guide template 10, and FIG. 2 is a guide template using the oral cavity MD prepared through the process of FIG. 1. 10 is a diagram showing a series of steps for producing.

The first step is to prepare an oral model (MD) modeled after the patient's intraoral tissue. As described above, the oral cavity model (MD) is a digital oral cavity made of a rapid molding machine or a 3D printer based on three-dimensional image data as well as an analog plaster model made by pouring plaster on a sound mold made of an impression material. Both models (MD) can be used. However, considering the manufacturing cost and time, and the minimum precision (shape followability) required, traditional gypsum models are sufficient, so it is not necessary to use digital expensive oral models.

Then, when the oral cavity model MD is prepared, the bushing 40 for inducing the progress of the drilling drill at the precise position where the implant procedure is planned is detachably fixed on the oral cavity model MD. That is, the treatment plan established in the computer program includes various geometric information about the position, angle, and depth of the implant as well as the length and diameter of the implant. After drilling the hole accurately, the bushing 40 is fixed by the fixing pin. For details, reference may be made to Patent Documents 2, 3, and 4.

When the oral cavity (MD) in which the bushing 40 is fixed at the correct position according to the procedure plan is prepared (see FIG. 1), the bushing 40 is included as shown in FIG. The first thermoplastic sheet S1 is disposed to cover at least a portion of the oral cavity MD, and a vacuum is applied between the first thermoplastic sheet S1 and the oral cavity MD while applying heat to the first thermoplastic sheet S1. By forming (VC), the first thermoplastic sheet S1 is brought into close contact with the surface of the oral cavity MD.

Here, the first thermoplastic sheet (S1) should be in close contact with the bushing 40, the oral model so as to secure a sufficient area that does not shake when the completed guide template 10 is inserted into the patient's mouth (MD) must be wrapped. Of course, the first thermoplastic sheet (S1) can be made to cover the entire oral cavity (MD), of course, but if the number of teeth of the patient is already sufficient or already another prosthesis can be made to cover only a portion.

And, heating the first thermoplastic sheet (S1) to an appropriate temperature is to give flexibility, it is sufficient to apply a heat in a range of 70 to 80 ℃ not melted, easy to hold and work by hand Do. As such, when the first thermoplastic sheet S1 having appropriate flexibility is placed on the oral cavity model MD and a vacuum (negative pressure) is formed therebetween, the first thermoplastic sheet S1 is oral cavity model ( MD) (including the bushing). In particular, since the pressure (atmospheric pressure) acts uniformly on the surface of the first thermoplastic sheet S1, the first thermoplastic sheet S1 can be brought into close contact with each other without being lifted along the complicated shape of the oral cavity MD.

Next, as shown in FIG. 2E, a thicker second thermoplastic sheet S2 is disposed over the first thermoplastic sheet S1 in close contact with the oral cavity MD, and the same as in the previous step. While applying heat to the second thermoplastic sheet S2 (70 to 80 ° C.), a vacuum VC is formed between the second thermoplastic sheet S2 and the first thermoplastic sheet S1 to form the first thermoplastic sheet S1. ) The second thermoplastic sheet S2 is attached to the surface.

Here, the thickness of the second thermoplastic sheet S2 is thicker than that of the first thermoplastic sheet S1. This is in close contact with the surface of the oral cavity (MD) having a complex shape by using a thin first thermoplastic sheet (S1) to accurately grasp the basic shape of the guide template 10, and then the thick second thermoplastic sheet (S2) It is for reinforcing structural strength by attaching on it.

If necessary, it is also possible to further bond the third and fourth thermoplastic sheets on the second thermoplastic sheet S2 in the same manner, but at least two layers of the first / second thermoplastic sheets S1 and S2 having different thicknesses. Creating a guide template 10 will be the key.

In addition, another advantage of making the guide template 10 into two or more layers of the first and second thermoplastic sheets S1 and S2 is that the patient information or the procedure time, the manufacturer's logo, It is possible to arrange one or more identification sheets 50 on which information including the surgical reference information is recorded, and to attach the second thermoplastic sheet S2 thereon. That is, in the related art, identification information is directly written or labeled on the surface of the guide template 10. In this case, there is a risk of being damaged by drugs, saliva, and moisture or adversely affecting the premises of the patient. In contrast, the applicant's guide template 10 seals the identification sheet 50 in which various pieces of information including patient information or procedure time, manufacturer logo, and surgical reference information are recorded between the overlapping thermoplastic sheet layers S1 and S2. The problem in the prior art is completely solved because it can be put in.

The first thermoplastic sheet (S1) and the second thermoplastic sheet (S2) as described above is at least any one selected from polyethylene (PE), polyvinyl chloride (PVC), acrylic (Acrylic), ABS (ABS), polycarbonate (Polycarbonate) One or more resin materials may be used, and the thickness of the first thermoplastic sheet S1 may be in the range of 0.3 to 0.75 mm, and the thickness of the second thermoplastic sheet S2 may be in the range of 0.5 to 3.0 mm.

When the first thermoplastic sheet S1 and the second thermoplastic sheet S2 are bonded to each other by using the oral cavity model MD as a form through the above-described series of processes, the first thermoplastic sheet S1 and the second thermoplastic sheet S2 are formed. By cutting the unnecessary edges of), the guide template 10 as shown in FIG. 3 is completed. Here, the guide template 10 is cut so as to surround a part of the undercut (U) beyond the maximum melt portion (H) of at least one of the buccal (B) and lingual (L) of the teeth to guide the template (10). When installed in the premises to the undercut (U) portion is elastically fitted so that there is no shaking. For reference, reference numeral “O” not described in FIG. 3 refers to an occlusal surface.

Here, when cutting the first thermoplastic sheet S1 and the second thermoplastic sheet S2 bonded together, a cutting tool such as a knife, a saw, a dental bur, or a laser LS may be used. In particular, in order for the guide template 10 to be stably mounted in the mouth, the guide template 10 must be accurately cut to sufficiently cover the undercut U in the buccal B and / or lingual L of the tooth. Since it is a small part of a few millimeters, there is a risk that the guide template 10 may be worn out due to small machining mistakes that can occur during manual operation.

Accordingly, the present invention provides an apparatus for accurately cutting the first thermoplastic sheet S1 and the second thermoplastic sheet S2 bonded to each other on the oral cavity MD.

4 is a perspective view showing an apparatus for manufacturing the guide template 10 according to the present invention, more precisely, a device for cutting the guide template 10.

The device shown is a robot arm 100 with six degrees of freedom. Six degrees of freedom of the robot arm 100 according to the present invention is connected to the six movements connected from the base 110 to the end of the work tool 170 in the order of "rotation-tilting-tilting-rotation-tilting-rotation" (RTTRTR). Is implemented. Here, "rotation" refers to a motion that can be rotated 360 ° without changing the distance between the arms connected to each other, "tilting" means that the angle between the arms can be changed within a certain range by the rotational movement of the arms connected to each other in the joint area It means exercise.

The structure of the robot arm 100 shown with reference to FIG. 4 will be described in more detail. However, in the detailed description, the configuration of the motor that is the power source of the rotation and tilting motion is omitted since it corresponds to a well-known configuration.

The base 110 rotates 360 ° about the vertical axis (Z axis). In addition, the first arm 120 connected to the base 110 performs a tilting motion (rotational movement about an axis of rotation on the XY plane perpendicular to the Z axis) in a vertical direction in which the height of the base 110 is changed. The second arm 130 connected to the first arm 120 may also be tilted in the same direction as the first arm 120.

The third arm 140 rotates 360 ° on a plane perpendicular to the longitudinal direction of the second arm 130, and the fourth arm 150 tilts about an axis perpendicular to the axis of rotation of the third arm 140. You exercise. In addition, the work end 160 connected to the end of the fourth arm 150 may perform a 360 ° rotational movement on a plane perpendicular to the longitudinal direction of the fourth arm 150, and the work end 160 may have two or more operations. The sphere 170 is mounted.

Robot arm 100 of the above structure is a structure suitable for processing the work object mounted on the worktable 200 from above. That is, as can be seen in the side view of Figure 5, the robot arm 100 of the present invention is a horseshoe-shaped dentition of the first thermoplastic sheet (S1) and the second thermoplastic sheet (S2) bonded to each other on the oral cavity (MD) Six degrees of freedom can be exercised in the order of "rotation-tilting-tilting-rotation-tilting-rotation" (RTTRTR) to work in and out of the palace.

The work tool 170 mounted on the work end 160 positioned at the distal end of the robot arm 100 is a laser cutter 172 and a marking pen 174. The laser cutting machine 172 is a work tool 170 that melts and cuts the thermoplastic sheets S1 and S2 by using the heat of a laser. When the thermoplastic sheets S1 and S2 are cut by a laser, the cutting state of the cut edge is excellent. Because it can reduce or omit post-processing, it is the most desirable cutting tool.

The cutting of the laser cutting machine 172 is performed in order not to severely melt and cut the thermoplastic sheets S1 and S2 having a total thickness of 0.5 to 3.0 mm in which the first thermoplastic sheet S1 and the second thermoplastic sheet S2 are bonded at once. The output should have an energy in the range of 20 to 60W per 0.01πmm2. However, the lower the output of the laser cutting machine 172 is preferable in order to prevent work safety problems and damage to the oral cavity MD by the laser of high power.

Therefore, the present invention is provided with a marking pen 174 on the working stage 160 as a way to lower the output of the laser cutting machine 172. The marking pen 174 is a kind of writing means for marking the opaque cutting line 180 on the surface of the second thermoplastic sheet S2 before cutting with the laser cutting machine 172. In order for the heat of the laser to act on the thermoplastic sheets S1 and S2 effectively, the laser light needs to be well absorbed by the thermoplastic sheets S1 and S2. Therefore, when the opaque cutting line 180 is drawn with the marking pen 174 in advance, the laser light absorption rate of the cutting line 180 is locally increased, so that even if the output of the laser cutting machine 172 is lowered once, It is possible to cut the thermoplastic sheets S1 and S2 on the substrate. By displaying the opaque cutting line 180, the output of the laser cutting machine 172 can be lowered to about 2 to 6W per 0.01πmm2.

Marking the opaque cut line 180 with the marking pen 174 brings many other advantages. One of them is that the output of the laser cutting machine 172 is considerably lowered, so that melting of the thermoplastic sheet S1 and S2 other than the portion where the opaque cutting line 180 is marked does not occur, and the cutting quality is remarkably improved.

In addition, the thermoplastic sheets S1 and S2 can be made of a completely transparent material. That is, when the thermoplastic sheets S1 and S2 are completely transparent, the laser light is hardly absorbed and most of the laser beams are transmitted. Therefore, it is very difficult to apply a laser of considerable high output power, but it is very difficult to apply them realistically. The laser cutting machine 172 may also be easily applied to the thermoplastic sheets S1 and S2 of a transparent material.

Making the guide template 10 with the transparent thermoplastic sheets S1 and S2 is beautiful in appearance, and even if a label (identification paper) for displaying surgical information is placed between the thermoplastic sheets, the readability is not degraded. Because it is easy to observe the surgical tissue and can almost eliminate the objection that the patient can feel, there are many functional and aesthetic advantages as well as clinically very practical. FIG. 6 is a photograph of an example in which the guide template 10 is manufactured from the thermoplastic sheets S1 and S2 of a transparent material.

The operation of the robot arm 100 is operated according to the input work information (positional information, work order, etc.) like other general robot arms capable of automatic operation. The movement path that draws the opaque property line and the laser cutting machine 172 moves along the opaque property line is established using 3D scan data or CT data of the patient's premises. As described above, the current dental procedure is basically a three-dimensional scan data or CT data obtained after the overall plan is established. Therefore, based on the image data showing the tissues such as teeth, gingiva, etc. already acquired before the production of the guide template, a cutting line that sufficiently covers the undercut (U) in the computer program is designed, and the designed work information is transferred to the robot arm 100. You can do this automatically by typing in.

While the preferred embodiments and embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that the present invention can be modified without departing from the spirit or principle of the invention. Could be. Therefore, the scope of the present invention will be defined by the description of the claims and their equivalents.

The present invention is suitable for producing a guide template, which is an aid that can guide the surgical procedure to proceed precisely as planned, in the case of implantation, especially dental implant placement.

Claims

A robot arm capable of six degrees of freedom motion connected in the order of "rotation-tilting-tilting-rotation-tilting-rotation" from the base to the distal working end; And

A laser cutting machine and a marking pen mounted on the working end;

Including,

A guide that displays an opaque cut line with the marking pen on the surface of the thermoplastic sheet adhered to the oral model, and cuts the thermoplastic sheet to be separated from the oral model with the laser cutting machine along the cut line. Template manufacturing device.
The method of claim 1,

The output of the laser cutting machine is a guide template manufacturing apparatus, characterized in that lower than the output capable of cutting the thermoplastic sheet without the cut at once.
The method of claim 2,

And the output of the laser cutting machine is in the range of 2 to 6 W per 0.01πmm 2.
The method of claim 1,

The thermoplastic sheet is a guide template manufacturing apparatus, characterized in that the transparent material.
The method of claim 1,

Wherein the cut line is displayed such that the thermoplastic sheet includes an undercut portion of a tooth on the oral cavity model.
The method according to any one of claims 1 to 5,

The thermoplastic sheet includes a first thermoplastic sheet that is in direct contact with the oral cavity model, and a second thermoplastic sheet bonded to an outer side of the first thermoplastic sheet and having a thicker thickness.
The method of claim 6,

Guide template manufacturing apparatus, characterized in that the thickness of the first thermoplastic sheet is 0.3 ~ 0.75mm.
The method of claim 7, wherein

The thickness of the said 2nd thermoplastic sheet is a guide template manufacturing apparatus characterized by the above-mentioned.
The method of claim 1,

The material of the thermoplastic sheet is a guide template manufacturing apparatus, characterized in that at least one resin selected from polyethylene (PE), polyvinyl chloride (PVC), acrylic (Acrylic), ABS (ABS), polycarbonate (Polycarbonate). .